Introduction: Staff in acute mental health settings work with voice hearers at times of crises, when experiencing high levels of distress. Research has demonstrated the importance of exploring the subjective experiences of voice hearing yet there has been little focus on staff experiences of working with voice hearers. The present study therefore sought to explore staff experiences of working with voice hearers in an acute mental health service. Method: Eight staff members (three mental health nurses and five healthcare support workers) from one acute mental health hospital were interviewed about their experiences of working with voice hearers. These interviews were transcribed and analysed using Interpretative Phenomenological Analysis. Individual analyses were conducted for each participant before conducting a group analysis. Results: Three master themes and seven super-ordinate themes were identified from the group analysis. Participants described ‘struggling to exercise control’ in their work with voice hearers, moving from positions of ‘powerlessness’ to ‘feeling powerful’. Participants experienced the ‘emotional impact of the work’ to different intensities, often going through an initial ‘startling phase’ and transitioning to feelings of ‘performance anxiety and self-doubt’. ‘Ways of managing feeling overwhelmed’ were described including going through a ‘process of making sense’, ‘forming relationships’ with voice hearers and feeling a ‘sense of duty and responsibility’. Discussion: The present findings relate to power literature and previous research on empowerment and control in mental health services. A parallel process was identified between voice hearers and staff, both experiencing an initial ‘startling phase’ but transitioning to an ‘organisational phase’ where they make sense of their experiences. The research findings were also consistent with previous studies demonstrating staff anxiety around opening up conversations about the content of voices, highlighting staff training and support needs.